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Biomedical subjects

P C Stomper

Publications and source records attributed to P C Stomper.

At least 73 records · Page 4Linked to original sources
PubMed1988

Planning mantle radiation therapy in patients with Hodgkin disease: role of gallium-67 scintigraphy.

Detection of all sites of lymphoma is imperative for accurate planning of radiation therapy. In patients with Hodgkin disease, mantle radiation is used to treat the thoracic lymph nodes; in those with early-stage or nonbulky disease, mantle and paraaortic radiation may be the only treatment given. CT scanning of the chest adds important information to that obtained from chest radiographs. Gallium-67 scintigraphy has also been used to provide additional information on sites of active tumor. To determine the usefulness of 67Ga-citrate scintigraphy in planning the portals for radiation therapy, we analyzed the radiation treatment plans in 26 consecutive patients with Hodgkin disease; in all 26 patients, the disease had been staged by chest radiographs, chest CT scans, and gallium-67 images. Gallium-67 imaging alone provided unique information that affected the treatment plans in three patients (12%). The combined results of gallium-67 imaging and CT scans influenced the planning of radiation therapy in eight patients (31%). Gallium-67 imaging was found to be an important adjunctive study for optimal planning of radiation therapy in patients with Hodgkin disease.

Gallium Radioisotopes↗
PubMed1988

Is mammography painful? A multicenter patient survey.

Anecdotal reports of pain experienced during mammography have been a source of anxiety and concern for some women considering screening. To determine what asymptomatic women actually experience during mammography, a survey of 1847 women was performed at seven breast-imaging centers. Women recorded their experience on a six-point scale ranging from no discomfort to severe pain. Eighty-eight percent of the women experienced no discomfort (49%) or mild discomfort (39%). Only 9% experienced moderate discomfort; 1%, severe discomfort; and 1%, moderate pain. No woman had pain so severe that it would make her reconsider having a mammogram again. The degree of discomfort was slightly greater in women who complained of breast tenderness within three days prior to the mammogram but was not strongly related to age, menstrual status, or week of the menstrual cycle. We conclude that in a vast majority of women mammography causes no or mild physical discomfort and that actual pain is an uncommon occurrence.

Adult↗
PubMed1988

Clinical significance of isolated scintigraphic sternal lesions in patients with breast cancer.

Isolated scintigraphic sternal lesions are rare. In a retrospective review of the bone scan results of 1,104 patients with breast cancer, 34 individuals (3.1%) presented with this abnormality. Of these foci, 26 (76%) were found to represent metastatic disease. There did not appear to be a relationship with axillary lymph node metastasis, the quadrant involved by primary breast tumor, or selected serum chemistries. These sternal lesions may be associated with regional lymphatic tumor spread rather than hematogenous seeding and therefore could be considered a local recurrence.

Bone Neoplasms↗
PubMed1987

Cavitary lung nodules associated with combination chemotherapy containing bleomycin.

We describe a patient in whom multiple cavitary lung nodules developed without infectious symptoms after treatment with bleomycin, cisplatin and vinblastine combination chemotherapy for metastatic testis cancer. Open lung biopsy demonstrated extensive granuloma formation without evidence of malignancy or infection. This report extends the spectrum of bleomycin pulmonary toxicity to include cavitary pulmonary nodules associated with granuloma formation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Mammographic detection of recurrent cancer in the irradiated breast.

Recurrence of cancer in the irradiated breast is an uncommon but potentially curable problem. Posttreatment mammograms were studied in 45 patients who had biopsies of an irradiated breast for suspected local recurrence to evaluate the usefulness of mammography in detecting such recurrences. Of 23 biopsy-proven recurrences, eight (35%) were detected by mammography only, nine (39%) were detected by physical examination only, and six (26%) were detected by both. Mammographic findings in recurrent malignancy included microcalcifications in six, microcalcifications associated with a mass in four, soft-tissue masses in three, and inflammatory changes in one. The results show that mammographic follow-up is complementary to physical examination in the detection of local recurrence in women who have undergone radiation therapy for early breast cancer.

Adult↗
PubMed1987

Detection of retroperitoneal metastases in early-stage nonseminomatous testicular cancer: analysis of different CT criteria.

To determine the predictive values of using different sizes on CT as criteria for the detection of retroperitoneal lymph-node metastases in patients with early-stage (nodes 5 cm or less in diameter) primary nonseminomatous testicular cancer, we performed a retrospective analysis of 51 patients. Measurements of lymph-node transaxial diameters on CT were correlated with histologic findings at lymph-node dissection or with response to initial chemotherapy. All patients had normal serum markers (alpha-fetoprotein, human chorionic gonadotropin) after orchiectomy. The frequency of lymph-node metastases in this population was 51%. When a CT criterion of 5 mm was used, the negative predictive value was 79%; the positive predictive value, 62%; the specificity, 44%; and the sensitivity, 88%. With a criterion of 15 mm, the negative predictive value was 63%; the positive predictive value, 71%; the specificity, 76%; and the sensitivity, 58%. Metastases in retroperitoneal lymph nodes that appeared within normal limits (i.e., had normal transaxial diameters) on CT were the limiting factor in the ability of CT to exclude the presence of metastases. We conclude that using smaller sizes on CT scans as the criteria for detection of lymph-node metastases cannot replace dissection of nodes in patients who have normal-sized nodes but may be helpful in identifying a subgroup of patients who are at lower risk of harboring metastases when treatment by orchiectomy alone is considered.

Humans↗
PubMed1986

CT evaluation of advanced seminoma treated with chemotherapy.

The serial CT characteristics of nodal metastases from pure seminoma treated with chemotherapy were evaluated in 18 patients. Fifty percent of masses at presentation contained areas of low attenuation; none had calcification. After chemotherapy, masses completely resolved in four patients, partially resolved in 12 patients, and remained unchanged in one patient. The remaining patient developed progressive liver metastases during therapy and died. Pathologic evaluation of residual masses in four patients demonstrated only fibrosis. Residual masses in nine other patients demonstrated further partial resolution or remained stable over the following year; two developed calcification. These patients exhibited no clinical evidence of disease for a median follow-up of 22 or more months. Persistent but stable or resolving masses are common after chemotherapy for advanced seminoma. Unlike their nonseminomatous counterparts, they most often represent fibrosis in patients with no other clinical evidence of disease and do not warrant surgical excision.

Adult↗
PubMed1985

Therapeutic guidelines and results in advanced seminoma.

Twenty patients with advanced seminoma were treated with chemotherapy. Fourteen patients were previously untreated (group 1) and received vinblastine, bleomycin, and cisplatin (VPB) at presentation. Six patients had received prior radiation therapy (group 2), and at relapse received either VPB or VP-16-213 (etoposide)-cisplatin. Within group 1, five patients received no further therapy after VPB (group 1A), six patients received radiation to residual radiographic abnormalities (group 1B), and three patients underwent surgery to remove residual radiographic areas following VPB (group 1C). The complete response rate in group 1 was 14/14 (100%). At present within group 1A, 5/5 patients (100%) are alive and disease-free (NED) for a median follow-up of 32 + months. In group 1B, 6/6 patients (100%) are alive and NED for a median follow-up of 17+ months. In group 1C, 3/3 patients (100%) had residual fibrosis at the time of surgical resection. Two of these patients died of postoperative complications with no evidence of disease and the third is alive and NED at 19+ months. In group 2, 4/6 patients (67%) achieved a complete remission, including two patients who are NED at 22+ and 85+ months, respectively. Two have died and two are alive with progressive disease. Doses of chemotherapy to group 2 patients were substantially lower than the doses given to group 1 patients. We conclude that chemotherapy is acceptable initial therapy for advanced seminoma, and prior extensive radiation therapy may impair the ability to give adequate doses of chemotherapy in patients who relapse. Residual masses after chemotherapy are often fibrotic and the role of postchemotherapy radiation therapy in these patients is uncertain.

Adult↗
PubMed1985

Residual abdominal masses after chemotherapy for nonseminomatous testicular cancer: correlation of CT and histology.

Computed tomographic (CT) characteristics of 45 residual masses in 30 patients with disseminated nonseminomatous testicular cancer treated with chemotherapy were correlated with histologic findings at surgery. Thirty-one masses were studied serially on pre- and postchemotherapy scans. At the time of tumor-reductive surgery, all patients had normal serum tumor markers (alpha-fetoprotein and human chorionic gonadotropin). Residual malignancy was found in 27% of patients, teratoma in 33%, and fibrosis or necrosis in 40%. The CT appearance of the masses--size, qualitative density, and change noted during the course of treatment--was insufficient to exclude the presence of residual malignancy or teratoma. An enlarging mass of psoas density occurred only once in this series; it contained malignancy. Other CT characteristics of residual masses had no greater than 50% correlation with the presence of malignancy. Histologic evaluation of residual masses remains necessary to guide further patient management.

Abdominal Neoplasms↗
PubMed1984

Impact of thoracic computed tomography on radiation therapy planning in Hodgkin disease.

Over 5 years, CT of the thorax was performed on 53 patients with Hodgkin disease and mediastinal lymphadenopathy prior to the institution of therapeutic irradiation. Information obtained from CT prompted major alterations in the plan of therapy in 11 of 53 (21%) of the patients. These included changes of treatment portal size, the addition of localized boost therapy, and a revision of diagnosis.

Combined Modality Therapy↗
PubMed1984

Oncologic diagnostic radiology: a model for implementation.

The implementation of an oncologic diagnostic radiology subspecialty would provide better communication between the radiologist and the clinician and a greater opportunity to teach the general principles of therapeutic radiology. Practical aspects of the development of a section in oncologic radiology are discussed.

Education, Medical↗
PubMed1984

Occult breast abnormalities: percutaneous preoperative needle localization.

The results of 500 preoperative radiographically guided localizations for occult breast lesions over a period of more than 5 years are described. Of the total, 117 (23.4%) were found to be malignant. Biopsy was prompted by abnormal calcifications in 41% (203/500) of the cases and by occult masses, areas of architectural distortion, or asymmetry in 59% (297/500). of 74 patients with carcinoma who underwent axillary lymph node sampling, 78% (58/74) were free of metastatic involvement.

Biopsy, Needle↗
PubMed1983

Adrenal insufficiency secondary to metastatic lung carcinoma: CT aided diagnosis.

A patient with adenocarcinoma of the lung associated with clinical and laboratory evidence of adrenal insufficiency is described. Bilateral adrenal masses were identified on computed tomography and percutaneous needle biopsy confirmed metastatic adenocarcinoma. There was some clinical improvement after treatment with corticosteroids. Consideration of this entity with appropriate diagnostic testing should result in more frequent recognition as well as palliation of attendant symptomatology.

Adenocarcinoma↗
PubMed1983

Large-cell lymphoma of the spleen: CT appearance.

CT and histopathological findings were correlated in 5 patients with large-cell lymphoma who presented with splenic enlargement. Prominent CT findings included splenomegaly with large solitary or multiple areas of low attenuation. The clinical presentation and operative findings are reviewed.

Humans↗